Patients with severe chronic kidney disease require dialysis e.g. Peritoneal Dialysis (PD). PD involves exchange of fluids and dissolved substances from the blood using the patient's peritoneum in the abdomen. The PD requires access to the peritoneal cavity where the peritoneal dialysis catheter is inserted which acts as a permanent pathway into the peritoneal cavity. The permanent catheter involves exchange of fluids and dissolved substances from the blood. The catheter is usually placed just below the side of the belly button. The catheter exit site is usually covered with a dressing and the catheter is taped to the skin to avoid infections and pulling on the exit site. However, frequent changing of the catheter involves repetitive adhering and removing tape from the skin, which may lead to serious skin inflammation. In addition, increased duration of PD may cause morphological changes in the peritoneal membrane. For example, inadequate solute clearance, ultrafiltration failure (UFF) and changes in peritoneal membrane transport properties may cause progressive damage to the peritoneal membrane, thereby leading to inability of the membrane to function properly. Such changes may also lead to Exit Site Infections (ESIs) and peritonitis.
In another instance, the catheter and the surgical dressing can also be contaminated by bacteria such as S. aureus or fungi, which can lead to an infection of the peritoneum thereby leading to ESIs and peritonitis.
Conventional arts such as topical mupirocin can reduce the risk of S. aureus induced ESIs and peritonitis. However, the topical mupirocin has a poor bioavailability 0.24% and has a short half-life of about 20-40 minutes, requiring repeated administration. Thus, such administration may lead to the development of antibiotic resistance in patients. In addition, the ointment contains alcohol which can degrade the catheter, leading to cracks in the catheter. Therefore, catheter needs to be changed frequently which can cause inconvenience to patients and skin inflammations.
Therefore, there exists a need for developing an alternative over the conventional arts which can prevent ESIs and peritonitis.